When the advocates of complementary and alternative medicine (CAM) push back against critics, they often point to the big CAM \u201csuccesses.\u201d The argument usually goes as follows: the heartless science-informed cynics have long said acupuncture (or some other CAM practice) doesn\u2019t work, but now it is accepted throughout the world! So the cynics are wrong about everything. Mic drop.<\/p>\n
This I-told-you-so approach is flawed on many levels. Let me touch on just a few.<\/p>\n
First, believe it or not, this isn\u2019t a contest. The wonderful thing about being science-based is that you can embrace stuff that works, regardless of where it comes from. If the evidence is compelling, let\u2019s use it. But if a practice that is associated (rightly or not) with CAM shows possible promise in a few limited contexts (for example, mindfulness<\/a>), this does not mean that, somehow, the already debunked CAM stuff works. It isn\u2019t a justification for ignoring what the evidence says about homeopathy, detoxes, ionic foot baths, chelation therapy, IV therapy, reiki, etc.<\/p>\n Second, and most important, the evidence surrounding the CAM \u201csuccesses,\u201d including acupuncture, hardly justifies the claim of a clear, mic-drop, in-your-face \u201cwin\u201d for woo-woo. On the contrary, despite decades of research, thousands<\/a> of studies and much debate, the evidence in support of acupuncture remains<\/a>, to put it kindly, confused<\/a>. Most systematic reviews, such as those done<\/a> by the Cochrane Collaboration, find either no benefit or insufficient or poor-quality<\/a> evidence<\/a> to make a strong recommendation for the use of acupuncture for almost any condition. And, in general, the better the methodological rigour of the study \u2014 such as utilizing randomized controlled trials that involve a sham treatment<\/a> arm \u2014 the more it seems like the (almost always small<\/a>) benefits can be attributed to a combination of regression to the mean (a.k.a., people usually get better on their own) and the placebo effect<\/a>.<\/p>\n There is no doubt that the placebo effect is, obviously, a thing (though we should take care not to overstate<\/a> its power or underestimate its complexity<\/a>). Recent studies have found, for example, that a placebo performance enhancer can lead to faster sprint<\/a> times. And it seems likely that using a placebo can provide benefit in a variety of clinical situations<\/a>.<\/p>\n In the context of CAM, the placebo effect may be particularly strong. Many CAM treatments are provided in an elaborate clinical setting that is often infused with the exotic and comes with an ancient and appealing historical backstory<\/a>. And, of course, you are usually paying for the service (recent research<\/a> has found that more expensive placebos are perceived to work better than cheaper placebos). All of this can create a powerful placebo theatre<\/a> that enhances the expectation and experience of benefit.<\/p>\n This raises an interesting policy challenge. If the alleged benefits of a CAM treatment are mostly (or even partly) due to the placebo effect, why not simply embrace this reality? Why not allow the construction and support of a variety of placebo theatres?<\/p>\n Indeed, some<\/a> have advocated for exactly this, pushing for the use of placebos in the clinical context and suggesting that practices should be structured to enhance the placebo effect. A clinical benefit is a clinical benefit, after all.<\/p>\n But there are deep problems with this approach. It is, for example, likely illegal<\/a> and unethical. At some level, it requires deceiving patients. (Yes, I am aware of the controversial studies that suggest a placebo may still work without deception<\/a>.) In Canada, you can\u2019t lie or withhold relevant information from a patient, even for the benefit of a patient. The law on informed consent demands that clinicians disclose what the relevant evidence says about a therapy. If the evidence says it doesn\u2019t work or that the evidence of benefit is weak or likely due, wholly or in part, to the placebo effect, this must be disclosed.<\/p>\n More broadly, withholding, minimizing or spinning what the available evidence says about a procedure may facilitate the legitimization of clearly harmful applications of the same technique. For instance, if we allow the maintenance of a placebo theatre for the purpose of, say, lower back pain, might this make it easier for practitioners to market the same procedure for other conditions for which there is clearly no benefit? Indeed, an erosion of critical analysis \u2014 which the maintenance of a placebo theatre demands \u2014 may facilitate a validation of the science-free or supernatural underpinnings of a practice. (In the case of acupuncture, this would be the idea that there is a life force energy that runs through well-defined meridians.) And there is some evidence that this is exactly what is happening. Some Canadian universities, for example<\/a>, make uncritical reference to acupuncture, suggesting it works with the \u201cbody\u2019s energy that flows along well-defined pathways called meridians.\u201d<\/p>\n Deception and the neglect of critical thinking is hardly a way to build a solid foundation for a sustainable health care system. And, in the long term, it is no way to maintain public trust. I want to be clear: I am open to the possibility that sticking needles into a person could have some kind of biological impact \u2014 though, to date, the research does not support the idea that acupuncture is a clear, slam-dunk, we-need-to-embrace-this therapy success story. (It is important to note that this placebo problem also exists with many common conventional procedures, including minor surgery<\/a> and many high-tech practices, like the use of platelet-rich plasma<\/a> for sports injuries.)<\/p>\n I have experienced acupuncture several times, in both Hong Kong and Canada. It was an entirely positive experience. Indeed, the placebo theatre was impressive. The caring practitioners, always dressed in white coats, diagnosed my health issues by looking at my tongue and feeling my pulse. They explained the meridian system and the flow of my \u201cchi\u201d using science-y-looking charts. It was a perfect marriage of the ancient with the trappings of the modern. The procedure was pain free and relaxing. I can genuinely understand why people enjoy the process \u2014\u00a0and why a placebo response is so common.<\/p>\n In reality, holding out acupuncture as an exemplar for CAM demonstrates the poor state of evidence surrounding most alternative therapies. If this is what a \u201cwin\u201d looks like, then calling the rest placebo-inducing hokum seems too kind.<\/p>\n Photo: Shutterstock, by B.Corn.<\/span><\/p>\n Do you have something to say about the article you just read? Be part of the\u00a0<\/em>Policy Options\u00a0discussion, and send in your own submission.\u00a0Here is a\u00a0<\/em>link<\/em><\/a>\u00a0on how to do it. <\/em>|\u00a0Souhaitez-vous r\u00e9agir \u00e0 cet article ? <\/em>Joignez-vous aux d\u00e9bats d\u2019<\/em>Options politiques\u00a0et soumettez-nous votre texte en suivant ces\u00a0<\/em>directives<\/em><\/a>.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":" When the advocates of complementary and alternative medicine (CAM) push back against critics, they often point to the big CAM \u201csuccesses.\u201d The argument usually goes as follows: the heartless science-informed cynics have long said acupuncture (or some other CAM practice) doesn\u2019t work, but now it is accepted throughout the world! So the cynics are wrong […]<\/p>\n","protected":false},"featured_media":274263,"template":"","meta":{"_acf_changed":false,"content-type":"","ep_exclude_from_search":false,"apple_news_api_created_at":"2025-10-08T01:53:04Z","apple_news_api_id":"fc39695b-fc36-48cc-b0a4-f961b66707fe","apple_news_api_modified_at":"2025-10-08T01:53:05Z","apple_news_api_revision":"AAAAAAAAAAD\/\/\/\/\/\/\/\/\/\/w==","apple_news_api_share_url":"https:\/\/apple.news\/A_DlpW_w2SMywpPlhtmcH_g","apple_news_cover_media_provider":"image","apple_news_coverimage":0,"apple_news_coverimage_caption":"","apple_news_cover_video_id":0,"apple_news_cover_video_url":"","apple_news_cover_embedwebvideo_url":"","apple_news_is_hidden":"","apple_news_is_paid":"","apple_news_is_preview":"","apple_news_is_sponsored":"","apple_news_maturity_rating":"","apple_news_metadata":"\"\"","apple_news_pullquote":"","apple_news_pullquote_position":"","apple_news_slug":"","apple_news_sections":[],"apple_news_suppress_video_url":false,"apple_news_use_image_component":false},"categories":[9372,9377,9383],"tags":[8681],"article-status":[],"irpp-category":[4286,4337,4382],"section":[],"irpp-tag":[],"class_list":["post-265729","issues","type-issues","status-publish","has-post-thumbnail","hentry","category-recent-stories-fr","category-sante","category-sciences-et-technologies","tag-alternative-medicine-fr","irpp-category-sante","irpp-category-science-et-technologie","irpp-category-soins-medicaux"],"acf":[],"apple_news_notices":[],"yoast_head":"\n
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